Body cavity illumination system

ABSTRACT

A cavity illumination system according to the present disclosure may include one or more illumination elements composed of a transparent or semi-transparent, biocompatible sterilizable polymer and one or more illumination sources. The sterilizable polymer operates as a waveguide. An illumination element may incorporate micro structured optical components such as for example gratings, prisms and or diffusers to operate as precision optics for customized delivery of the light energy. The micro structured optical components may also be used to polarize and/or filter the light energy entering or exiting the illumination element.

RELATED APPLICATIONS

This application claims priority from U.S. Provisional patentapplication 60/681,074 filed May 13, 2005 and U.S. Provisional patentapplication 60/681,119 filed May 13, 2005 and U.S. Provisional patentapplication 60/681,089 filed May 13, 2005.

FIELD OF THE INVENTIONS

The inventions described below relate to the field of medicine and morespecifically, to providing body cavity illumination for use by doctorsand dentists during medical and dental procedures.

BACKGROUND OF THE INVENTIONS

Various illuminating means have been employed in the past to illuminatenatural cavities within the human body in order to facilitateexamination and performance of medical procedures by medicalprofessionals. Illumination devices currently on the market employprojected, directional light. Some devices such as commerciallyavailable specula have their lighting means disposed on the lower bladesof the specula where a heavy discharge, e.g., a vaginal discharge, canpool and obscure the light source. Other devices employ projecteddirectional light, however, these illumination means merely provideillumination in a capacity limited to the area directly in front of thedevice or the optical fiber. These drawbacks make it difficult formedical personnel to perform examinations or procedures because theirability to see is diminished due to poor illumination.

Conventional methods of illumination in dentistry primarily consist ofthe use of overhead lighting or the use of head mounted lighting bydental professionals. Although these methods have been used for manyyears, they have many drawbacks. During dental examinations andprocedures, dentists are often positioned between the light source andthe patient's mouth, which blocks the light and creates shadows in thepatient's mouth making it difficult to see.

It is frequently necessary in medical procedures to insert anendotracheal tube into the trachea of a patient for the purpose ofperforming diagnostic tests or for the introduction of some means ofventilation, oxygenation, and/or airway protection. Even in the bestsituations, intubation is often difficult and can give rise tocomplications. In many patients, establishment of the airway isparticularly difficult due to morphologic anomalies such as a largetongue, excessive pharyngeal or laryngeal soft tissue, or trachealdisplacement, as well as physiologic events such as laryngospasm,regurgitation of gastric materials, bleeding, or foreign bodiesaspiration. These morphologic anomalies and/or events make it difficultto visualize the posterior pharyngeal area and larynx with conventionallaryngoscopic maneuvers. In emergency situations, attempts to intubatesuch patients are difficult and time consuming. Inability toexpeditiously intubate the patient and protect the airway can lead tosignificant hypoxemia, myocardial ischemia, and brain injury. Cases ofdeath have also been related to complications caused by the inability toquickly and clearly see the larynx and trachea. Proper illumination iscritical to safely and quickly insert an endotracheal tube into apatient.

Conventional laryngoscopes are often only able to provide illuminationto the area directly in front of the blade or the optical fiber. Thesedrawbacks make it difficult for medical personnel to perform intubationsbecause their ability to see is diminished due to poor field ofillumination.

Anoscopes are used to view the anal cavity and lower rectum.Illumination is provided with a fiber optic light pipe that providesonly a spot of light that must be moved around to view the cavity. Someanoscopes are provided with fiber optic fibers arranged in a ring aroundthe tip of the device. Such devices are very expensive to manufactureand only provide a ring of light due to the small divergence angle ofthe fiber optic light output, thereby poorly illuminating the cavitywalls.

An inefficient waveguide in conventional devices may experiencesignificant light loss; typically 60% of light may be lost from input tooutput. Such a light guide would require a high power LED to providesufficient light. A high power LED requires a lot of power and generatessignificant heat, thereby requiring large batteries and bulky andinconvenient heat sinking devices and methods that add to the size andincrease the difficulty of using such a device. Other high power lightsources often require noisy fans, which may disturb the medicalpersonnel conducting a surgery or medical exam.

What is needed is a more effective, simple and inexpensive means ofilluminating body cavities.

SUMMARY

A cavity illumination system according to the present disclosure maycomprise one or more illumination elements composed of a transparent orsemi-transparent, biocompatible sterilizable polymer and one or moreillumination sources. The sterilizable polymer operates as a waveguide.An illumination element may incorporate micro structured opticalcomponents such as for example gratings, prisms and or diffusers tooperate as precision optics for customized delivery of the light energy.The micro structured optical components may also be used to polarizeand/or filter the light energy entering or exiting the illuminationelement.

For example, a dental retractor may have a substantially U-shapedwaveguide to confine and guide a propagating electromagnetic wave. Whenin use, the light source in the dental retractor provides anelectromagnetic wave, which is confined and guided by the polymerresulting in the illumination of the oral cavity.

Alternatively, an external reusable light source may be attached to thedisposable dental retractor to provide a source of light, said lightbeing guided by the waveguide to optical structures specificallydesigned to illuminate particular areas of the oral cavity. Othersimilar dental devices may be so configured to provide illumination ofthe oral cavity, for example, cheek retractors, cheek expanders,combination lip and cheek retractors, tongue shields, bite blocks,intra-oral mirrors used in photography, and the like.

In an alternate example, an illuminated laryngoscope may include adisposable blade comprising a biocompatible sterilizable polymer. Whenin use, the light source in the blade, or in optical communication withthe blade provides an electromagnetic wave, which is confined and guidedby the polymer resulting in the illumination of the trachea of thepatient.

In modern practice, a non-disposable metal blade is often preferred dueto the forces applied during use. In an alternate configuration, adisposable waveguide may be attached to the metal blade or inserted intoa groove in the metal blade. When in use, the light source in thewaveguide, or in optical communication with the waveguide provides lightthat is confined and guided in the waveguide until it reaches opticalstructures for directing the outgoing light to selected areas to beilluminated.

In another example, a speculum illumination system may comprise agynecological speculum having detachable blades comprising abiocompatible sterilizable polymer. The illumination source is inoptical communication with the blades the sterilizable polymer functionsas a waveguide.

A body cavity illumination system waveguide is designed and fabricatedto optimize light transfer from the light source or fiber optic inputcable and minimize light loss from the waveguide in order to provide anefficient light transmission system. Efficiency is particularlyimportant for LED and other light sources, e.g., tungsten or xenonlamps, because it directly determines the required brightness of theLED. An efficient waveguide, one in which light loss is typically lessthan 30%, allows a much lower power LED or other light source to beused, thereby significantly reducing or eliminating the need for specialheat sinking devices and methods and improving the usability of thedevice. The design of an efficient body cavity illumination waveguidemay involve special design of the light input portion of the waveguideto efficiently capture the incoming light, design and fabrication of thelight reflecting walls of the waveguide to maintain surface finish tomaximize reflection and reduce light lost through refraction, the use ofreflective or dampening coatings, the design of light directing opticalstructures that direct the light toward the light output opticalstructures while minimizing light loss through refraction, and/or thedesign of light output optical structures that maximize light exitingthe waveguide through refraction, particularly refraction of light incertain directions, while minimizing light lost through reflection.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a front view of a patient's oral cavity during a dentalexamination using a cavity illumination system according to the presentdisclosure.

FIG. 2 is a side view of an alternate cavity illumination configuration.

FIG. 3 is a top view of an alternate cavity illumination configurationas a dental retractor with a handle.

FIG. 4 is a top view of an alternate dental retractor cavityilluminator.

FIG. 5 is a top view of a dental retractor cavity illuminator with lightdirecting structures.

FIG. 6 is a top view of a dental retractor cavity illuminator with lightdirecting structures in the handle.

FIG. 7 is a cutaway view of the dental retractor cavity illuminator ofFIG. 6.

FIG. 8 is a top view of a cheek retractor cavity illuminator accordingto the present disclosure.

FIG. 9 is a side view of a laryngoscope cavity illuminator in use.

FIG. 10 illustrates a laryngoscope illumination system with anillumination source in the blade.

FIG. 11 illustrates a laryngoscope illumination system with anillumination source in the handle.

FIG. 12 is a side view of an alternate laryngoscope illuminatoraccording to the present disclosure.

FIG. 13 is a side view of a metal blade laryngoscope including anilluminator waveguide engaging the blade.

FIG. 14 is a cutaway view of the laryngoscope cavity illuminator of FIG.13 taken along B-B.

FIG. 15 is a side view of a laryngoscope cavity illuminator waveguide.

FIG. 16 illustrates the Speculum Illumination System.

FIG. 17 is a side view of the cavity illumination system of Figure withthe handles closed.

FIG. 18 is a side view of an alternate cavity illumination system withthe illumination source in the handle.

FIG. 19 is a side view of another alternate cavity illumination system.

FIG. 19A is a cutaway view of the blade of cavity illumination system ofFIG. 19 taken along C-C.

FIG. 19B is a cutaway view of an alternate blade of cavity illuminationsystem of FIG. 19 taken along C-C.

FIG. 20 is a side view of still another alternate cavity illuminationsystem.

FIG. 21 is a top view of yet another cavity illumination systemaccording to the present disclosure.

FIG. 22 is a cutaway view of the cavity illumination system of FIG. 21taken along D-D.

DETAILED DESCRIPTION OF THE INVENTIONS

FIG. 1 illustrates a patient's oral cavity 1 during a dentalexamination. The patient's mouth is opened with a cheek or dentalretractor, exposing the patient's teeth 2. The dental retractorcomprises biocompatible sterilizable polymer that acts as a waveguideand further comprises an illumination source 3. The illumination sourcecomprises an LED (light emitting diode) 4, battery 5, a conductor 6electrically connecting the battery and the LED, and an LED controlcircuit 7 and switch 8. The switch may have pressure sensor causing aconnection between the battery and the LED when the patient's lips orcheeks press against the retractor and resulting in illumination. TheLED is preferably a white-light LED, which provides a bright, whitelight. The battery may be provided in any form, but is preferably alithium ion polymer battery provided in small, conformal case. Thecontrol circuit, including a switch, is provided in the case or anyconvenient location.

Dental illumination system 53 of FIG. 2 is integrated into a dentalmirror. An illumination source is integrated into handle 55. Theillumination source includes switch 56, battery 57, any suitableswitching and drive circuit such as circuit 58 and a suitable lightelement such as LED 54, preferably a bright white LED. The battery maybe of any suitable type, preferably a lithium ion polymer battery. Lightis conducted into the cavity using waveguide 59 with an input portion 60positioned next to the LED to capture the light emitted from the LED.The waveguide exits the handle and forms a frame 61 for mirror 62.

Alternatively, top face 61 t of the waveguide may be coated with amirror finish to implement the mirror. Output optical structures such asstructures 63 may be located where the waveguide exits the handleportion to shine light into the mirror that is then reflected to theanatomical structures to be viewed. Alternatively, output opticalstructures such as structures 64 may be situated on top waveguidesurface 61 t along the periphery of the mirror. Light emanating fromthese structures is directed upwards to illuminate the anatomicalstructures viewed in the mirror. These structures may be speciallydesigned to reduce the light directed toward the user and/or maximizethe light directed toward the anatomical structures to be viewed.

The bottom side of the waveguide frame, surface 61 b, may also containoutput optical structures such as structures 65 to illuminate anatomicalstructures when the mirror is reversed and used as a retractor. Outputoptical structures 65 on the bottom surface of the waveguide frame maybe placed along the periphery, along a portion of the waveguide frameface, and/or across the entire area of the bottom surface. The waveguideframe may also include light directing structures to direct light fromthe input portion to the output portion of the waveguide frame. Lightoutput structures may be combined, such as structures 63 for use withthe mirror and structures 65 for use as a retractor, or structures 64for use with the mirror and structures 65 for use as a retractor.Waveguide frame 59 is designed to maximize light transmission efficiencyto enable use of a lower power LED, thereby allowing a smaller heat sinkand smaller batteries that then allow the handle to be smaller in sizeand easier to manipulate by a user.

Waveguide 59 may also be modified to direct light while thehandle/waveguide assembly is secured to a dental drill, therebyproviding illumination during drilling. Alternatively, the drill itselfmay be modified to include a fiber optic bundle in the drill cable andallow a disposable waveguide to be connected to this light source fordrilling, then disposing of the waveguide after the procedure isfinished.

FIG. 3 illustrates a cavity illumination system for dental proceduresusing a dental retractor 16 with a U-portion 17 and a handle portion 18.The dental cavity illumination system comprises retractor 16 with anillumination source comprising an LED 20, battery 21, LED control 22circuit, and switch 23 secured within handle 18. In this figure, the LEDis mounted on the handle portion of the retractor and the illuminationsource further comprises an optical fiber 24 communicating from the LEDto the U-shaped portion of the retractor. The U-shaped portion of theretractor acts as a waveguide and the optical output of the opticalfiber travels through the U-shaped portion. The optical fiber is securedin a channel provided in the retractor. The handle portion of thisretractor may serve as a heat sink for dissipating the heat generated bythe LED, and additional heat sinks structures may be added. The handleportion assembly may also be manufactured and provided separately fromthe U-shaped portion of the retractor. This way, the U-shaped portionmay be packaged separately from the handle portion to enable disposableuse of the U-shaped portion with a non-disposable handle portion. Theassembly may also be integrated into the retractor, and provided insterile packaging in kits of retractors assembled to support dentalprocedures. Depending on the type of retractor, the waveguide may bedesigned to include channels for suction and irrigation, therebyproviding an integrated dental device.

FIG. 4 shows a lip retractor waveguide 66 with a connector 67 at thehandle end for connecting the waveguide to a fiber optic cable such ascable 68, which is connected to a suitable light source such as source69. Handle portion 66 h of the waveguide is designed and constructed tosupport total internal reflection of the light entering the waveguidefrom the fiber optic cable. Light travels down the handle where itspreads into U-shaped portion 70 and exits the waveguide through outputoptical structures 71 specifically designed to direct the light atparticular locations, e.g., as spots or bands of light along the gumline or as a more diffuse light illuminating the gum line and teeth fora particular number of teeth or as a diffuse light illuminating the oralcavity, or some combination thereof.

Waveguide 66 may also include a light directing structure 72, in thiscase a prism that may be formed of a cutout or by insert molding amaterial of suitably different refractive index relative to thewaveguide material, such structure serving to direct light toward theoutput optical structures located at the ends of the curved retractingportion to illuminate specific areas of the oral cavity.

Waveguide 75 of FIG. 5 includes light directing structures 76 on outersurface 77 of handle 78 or along the transition 79 of the handle to theU-shaped portion 80 or along the U-shaped portion that serve toefficiently direct the light into and along the U-shaped portion tomaximize the amount of light 81 exiting the output optical structures 82located along a substantial length of the curved retracting portion toilluminate a broad area while minimizing light loss in the waveguide.

Cavity illuminator 85 of FIGS. 6 and 7 includes output opticalstructures 86 located in handle portion 85 h or the transition portion87 between the handle and curved retracting portion 88. The location ofoutput structures 86 as illustrated, serving to illuminate the frontteeth, gums or other anatomical structures toward the front of themouth. In an alternate configuration, optical output structures in thehandle or transition portion may be combined with one or more lightdirecting structure, e.g., a prism, and optical output structures alongthe curved retracting portion to direct light both at or from the frontof the oral cavity as well as the sides of the oral cavity to illuminateoral anatomical structures for examination or treatment.

FIG. 8 illustrates a cavity illumination system using a cheek retractor.The cavity illumination system comprises a cheek retractor 25manufactured from a biocompatible sterilizable polymer that istransparent or semi-transparent and acts as a waveguide. The retractorhas an illumination source disposed therein. The illumination sourcecomprises an LED 26 or other light source, a battery 27, a LED controlcircuit 28, and a switch 29. When in use, the light source in the cheekretractor provides an electromagnetic wave that propagates through thepolymer resulting in the illumination of an oral cavity.

A cheek retractor cavity illuminator may also include a connectorportion that allows connection to an external light source eitherdirectly or through a suitable light conduit, for example, a fiber opticcable. Light entering the connector portion may be propagated throughthe waveguide via total internal reflection to optical output structureslocated on a suitable surface. Light directing structures may be locatedon the external wall of the cheek retractor waveguide or within the bodyof the waveguide.

FIG. 9 illustrates a laryngoscope illumination system in use on apatient 30. The laryngoscope 31 includes a handle 32 and a blade 33. Thehandle 32 allows for grasping the laryngoscope 31. The blade 33 is rigidand is attached to and extending from the handle. The blade comprisesbiocompatible sterilizable polymer that acts as a waveguide and furthercomprises an illumination source. The blade is for inserting into themouth 34 of a patient to allow viewing of a portion of the mouth, thepharynx, and the larynx of the patient 30. The blade is used to depressthe tongue 35 and mandible in order to prevent the tongue 35 of thepatient 30 from obstructing the view of the medical professional duringexamination. When the illumination source is illuminated,electromagnetic waves (light) are able to propagate through the bladeand illuminate the mouth and trachea of the patient.

FIG. 10 illustrates the laryngoscope 31 of the laryngoscope illuminationsystem in further detail. The laryngoscope 31 includes a handle 32 and ablade 33. The blade comprises a biocompatible sterilizable polymer thatacts as a waveguide. The blade may have an illumination source disposedtherein. The polymer may be transparent or semi-transparent. Theillumination source disposed within the blade comprises one or more LEDS36 (light emitting diodes), battery 37, a conductor 38 electricallyconnecting the battery and the LED, and an LED control circuit 39 andswitch 40. The LED is preferably a white-light LED, which provides abright, white light. The battery may be provided in any form, but ispreferably a lithium ion polymer battery. The blade may also bedetachable from the handle and disposable. The illumination source is inoptical communication with the blade. When the illumination source isilluminated, light from the illumination source propagates through theblade illuminating the blade.

FIG. 11 illustrates an alternate laryngoscope illumination system withthe illumination source in the handle of the laryngoscope 31. Thelaryngoscope 31 includes a handle 32 and a blade 33. The blade comprisesa biocompatible sterilizable polymer that acts as a waveguide. Thehandle has an illumination source disposed therein. The polymer in theblade may be transparent or semi-transparent. The illumination sourcedisposed within the handle comprises one or more LEDs 36 (light emittingdiodes), battery 37, a conductor 38 electrically connecting the battery37 and the LED 36, an LED control circuit 39, a switch 40 and an opticalfiber 41 in optical communication between the LED 36 and the blade 33.

The light output 90 of the optical fiber travels to one or more lightdirecting surfaces such as surface 91 where it is directed toward outputoptical structures 92 on any suitable surface of the blade. Outputoptical structures 92 may direct illumination to particular anatomicalareas through refraction while minimizing reflection that contributes toloss of light. The LED is preferably a white-light LED, which provides abright, white light. The battery may be provided in any form, but ispreferably a lithium ion polymer battery. The optical fiber 41 issecured in a channel provided in the laryngoscope 31. LED 36 may bepositioned in closer proximity to blade 33 such that light from LED 36is captured directly by blade 33, perhaps using optical structures onthe light input portion of blade 33 that efficiently capture light fromLED 36, thereby obviating the need for optical fiber 41. The handle 32of this laryngoscope may serve as a heat sink for dissipating the heatgenerated by the LED, and additional heat sinks structures may be added.The handle may also be manufactured and provided separately from theblade of the laryngoscope 31. This way, the blade 33 may be packagedseparately from the handle to enable disposable use of the blade 33 witha non-disposable handle 32. When the illumination source is illuminated,light from the illumination source propagates through the optical fiberto the blade illuminating the blade 33. This in turn can illuminate themouth and trachea of a patient.

Cavity illuminator 93 of FIG. 12 includes a waveguide insert 94 attachedto blade 95. The waveguide insert may be attached to the blade surface,e.g., with a suitable adhesive or other attachment means, or may beinserted into a channel formed in the blade to receive and hold theinsert. The blade and handle may be separate pieces or integrated as asingle device. In this embodiment, light from optical fiber 41 injectslight into waveguide insert 94, said light traveling along the waveguideinsert to exit at one or more optical output structures positioned atone or more designated areas of the waveguide insert. Optical fiber 41may be replaced by any other suitable light conduit, such as a rigid orflexible light pipe or waveguide.

Referring now to FIGS. 13 and 14, cavity illumination system 96including waveguide insert 97, the waveguide insert having an inputconnector 98 to couple light into the waveguide insert from an externallight source, such as a fiber optic cable connected to xenon or tungstenlight source as shown in FIG. 4. Waveguide insert 97 may engage achannel 95 c in the blade. The channel is designed to engage the insert.The waveguide insert may be made from a suitable hard plastic, such aspolycarbonate or acrylic. The waveguide may also be made from a flexibleoptical material, such as silicone, and may be supplied with astiffening member to make it easier to insert the flexible waveguideinto the channel in the blade. The waveguide may be made to be singleuse disposable or made to be suitable for multiple uses. The lightsource contained in the blade injects light into the waveguide insert,said light then is contained in the waveguide and travels to outputoptical structures in the waveguide insert that direct light toparticular anatomic areas.

Waveguide insert 97 as shown in FIG. 15 may include output opticalstructures such as structures 101 in one or more suitable locations todirect light to any appropriate anatomical areas. Output opticalstructures 101, here, stair stepped facets, running a portion of thelength of the top surface of the waveguide insert, each of said facetscausing a portion of the light 102 to exit the waveguide insert in apredetermined direction while minimizing light lost due to reflection atthese structures in order to maintain high transmission efficiency. Ifthe output optical structures abruptly end at an end face, light willshine out of this end face. However, the light that exits the end facemay not serve as useful illumination and, hence, may be considered lostlight that lessens the efficiency of the waveguide insert. To improveefficiency, one or more optical structures 104 may be arranged on bottomsurface 100 b of to direct light out of the corresponding top surfaceloot, which may have microstructured optical components to diffuse orfurther direct the light 103. Combining the bottom face output opticaloutput structures 104 with the top face output optical structures 101increases the transmission efficiency of the waveguide insert.

FIG. 16 illustrates the speculum illumination system. Gynecologicalspeculum 42 includes a first handle 43, a second handle 44, an upperblade 45 and lower blade 46. The upper blade 45 and lower blade 46comprise a biocompatible sterilizable polymer that functions as awaveguide. The polymer may have holographic or complex prismaticproperties and is designed to maximize light transmission efficiency toallow the use of lower power light sources. Each blade may engage anillumination source or have an illumination source disposed therein. Thepolymer may be transparent or semi-transparent. The illumination sourcedisposed within the blades comprises one or more LEDs 47 (light emittingdiodes), battery 48, a conductor 49 electrically connecting the batteryand the LED, and an LED control circuit 50 and switch 51. The LED 47 ispreferably a white-light LED, which provides a bright, white light. Thebattery may be provided in any form, but is preferably a lithium ionpolymer battery. The blades may also be detachable from the handle anddisposable. The illumination source is in optical communication with therespective blade. When the illumination source is illuminated, lightfrom the illumination source propagates through the blade providingillumination from appropriate areas of the blade.

Referring now to FIG. 17, handles 43 and 44 are closed to separateblades 45 and 46. In this orientation, blades 45 and 46 may direct lightinto the cavity in which the device is engaged. Any suitable structure,or structures such as coating 53, facets 54 and or micro opticalstructures 55 may be incorporated into blades 45 and or 46 to controland direct illumination, however, such structure or structures must bespecifically designed to maximize light transmission efficiency andminimize light loss and must be specifically designed to direct light tospecific anatomic structures. For example, structures 54 may designed todirect more diffuse light to illuminate a substantial portion of thevaginal wall, or may be designed to direct more focused light toilluminate the cervix at the end of the vaginal cavity, or may bedesigned to provide both types of illumination. Single or multiplerefractive and/or reflective structures, which may be combined withmicrostructured optical components, may be used to maximize lighttransmission efficiency to allow lower power light sources to be used,thereby reducing heat generation and the need to provide cumbersome heatmanagement devices and methods.

FIG. 18 illustrates an alternate cavity illumination system with theillumination source in the handles 43 and 44 of the speculum 42. Thespeculum 42 includes a first handle 43, a second handle 44, an upperblade 45 and lower blade 46. The blades 45 and 46 comprise abiocompatible sterilizable polymer that functions as a waveguide. Thepolymer may have holographic or complex prismatic properties and isdesigned to maximize light transmission efficiency to allow the use oflower power light sources. The handles have an illumination sourcedisposed therein. The polymer in the blade may be transparent orsemi-transparent. The illumination source disposed within one or bothhandles comprises one or more LEDs 47 (light emitting diodes), battery48, a conductor 49 electrically connecting the battery and the LED, anLED control circuit 50, a switch 51 and an optical fiber 52 in opticalcommunication with the LED and a blade. The optical output of theoptical fiber 52 travels through the blade illuminating the anatomicalarea(s) of interest. The LED is preferably a white-light LED, whichprovides a bright, white light. The battery may be provided in any form,but is preferably a lithium ion polymer battery. The optical fiber issecured in a channel provided in the speculum. The handles of thisspeculum may serve as a heat sink for dissipating the heat generated bythe LED, and additional heat sinks structures may be added. The handlesmay also be manufactured and provided separately from the blades of thespeculum. This way, the blades may be packaged separately from thehandle to enable disposable use of the blade with a non-disposablehandle. When the illumination source is illuminated, light from theillumination source propagates through the optical fiber to the bladesilluminating the upper blade and lower blade. This in turn canilluminate the vaginal cavity a patient.

Speculums with metal blades continue to be used. If a metal speculum ispreferred, then a disposable waveguide insert, similar to that shown inFIG. 19 or FIG. 20, may be provided.

Speculum 110 of FIG. 19 may be a disposable speculum comprised of anilluminating bottom blade 111 (waveguide blade) and a non-illuminatingtop blade 112. Waveguide blade 110 has an input connector 113 for asuitable light source, such as a fiber optic cable 115 connected to anexternal xenon light source 114. Light 116 enters the connector portionof the waveguide blade and travels up the handle portion to a lightdirecting structure 117, which directs the light 90 degrees toward theoutput optical structures 118 and 119 located along the bottom bladeportion.

If bottom blade 111 has a solid cross-section as shown in FIG. 19A,output optical structures such as structures 118 and 119 may extend thefull width 120 of blade 111 as well. If the bottom blade has acup-shaped cross-section as shown in FIG. 19B, separate output opticalstructures may be located on edge faces 121 and 122 as well as onconcave surface 123. The output optical structures direct light tospecific anatomic areas and such light may be more diffuse, morefocused, or a combination of each. The waveguide blade may be fabricatedwith suitable waveguide material as an optical element co-molded orover-molded with a suitable non-optical material as a structuralelement. The waveguide blade is normally designed to maximize lighttransmission efficiency.

Cavity illumination system 130 of FIG. 20 may include two waveguideblades, 111 and 125. The bottom waveguide 111 is as described for FIG.19. Top waveguide blade 125 may include a connector 128 for a separatelight source or both the top and bottom waveguide blades may beconnected to the same light source 126. Top waveguide blade 125 may notneed internal light directing structures, such as structure 117 in blade111, because its normal geometry may provide suitable reflectingsurfaces for directing light 131 toward the output optical structures125 a and 125 b. Top waveguide blade may have a similar output opticalstructure as the bottom waveguide blade. Together, the two bladesprovide even illumination of the entire cavity wall. Each waveguideblade may be designed to maximize light transmission efficiency.Alternatively, each blade may have different output opticalcharacteristics to provide complimentary illumination, each bladeilluminating different areas or anatomy.

FIG. 21 illustrates a side view of an illuminating anoscope waveguide140 with a proximal end 141 and a distal end 142 that is inserted into apatient's natural cavity such as the anal cavity. The anoscope waveguide143 may also be used as a general speculum. The anoscope waveguide isnormally molded from a suitable optical material, such as polycarbonateor acrylic. It may also include an input connector 144 that serves toconduct light into the waveguide such that light is conducted around theentire circumference of the waveguide tube. Output optical structures145 are typically placed near the distal end on the inside wall 146along all or a portion of circumference 147. Output optical structuresplaced on the end face 148 or outside wall 149 might cause irritation tothe cavity walls during insertion. If output optical structures arerequired on end face 148 or outside wall 149, any suitable coating ormaterial may be used to lessen the irritation. The output opticalstructures provide even illumination of the entire cavity wall. Thewaveguide is designed to maximize light transmission efficiency. Forexample, a reflective or prismatic surface may be created on theproximal end face to send mis-reflected light rays back toward thedistal output optical structures.

Referring now to FIG. 22 shows an example of a light directing structurethat contributes to light distribution around circumference 147. Lightentering input connector 144 may be directed by a light controlstructure, such as structure 150, which splits the incoming light andsends it down into the waveguide tube wall at an angle ensuringcircumferential light distribution.

Thus, while the preferred embodiments of the devices and methods havebeen described in reference to the environment in which they weredeveloped, they are merely illustrative of the principles of theinventions. Other embodiments and configurations may be devised withoutdeparting from the spirit of the inventions and the scope of theappended claims.

I claim:
 1. A cavity illumination system comprising: a laryngoscopehaving a handle and a blade, said blade having an upper surface, a lowersurface, a distal end, and a proximal end, wherein the blade is adaptedto engage tissue and prevent the tissue from obstructing the cavity; anillumination waveguide sized and dimensioned to engage and conform tothe blade, the waveguide having an upper portion, a lower portion, adistal end for emitting light, and a proximal end for receiving light,wherein the blade is adapted to be disposed between the tissue and theillumination waveguide, and wherein thickness of the illuminationwaveguide changes between the proximal and distal ends thereof; aplurality of light directing facets formed in the lower portion of thewaveguide for directing light laterally out through the upper portion ofthe waveguide towards a particular anatomical area, the plurality oflight directing facets directing the light through refraction; aplurality of output optical structures formed in the upper portion ofthe waveguide for directing light from the upper portion of thewaveguide laterally to the particular anatomical area, the plurality ofoutput optical structures directing the light through refraction; and anillumination source in optical communication with the proximal end ofthe waveguide.
 2. The cavity illumination system of claim 1 wherein theoutput optical structures on the upper portion comprise one or morefacets.
 3. The cavity illumination system of claim 2, wherein the one ormore facets comprise stair stepped facets.
 4. The cavity illuminationsystem of claim 1 wherein the output optical structures on the upperportion comprise micro-optical structures.
 5. The cavity illuminationsystem of claim 1 wherein the illumination waveguide conducts light fromthe proximal end to the distal end using total internal reflection. 6.The cavity illumination system of claim 1, wherein the upper and lowerportions are fiat.